447 research outputs found
Caustic Ingestion in Children
Caustic ingestion (CI) is an unfortunate event that occurs in families with a poor prevention culture. Its prevalence is unknown in developing countries; it occurs mainly in children < 5 years and is more common in boys. The chemical caustic agents are alkaline (85%) or acid products stored in food or beverage containers without warning labels and safety caps. The immediate symptoms include salivation, oropharyngeal burns, vomiting and oropharyngeal/retrosternal pain. Upper endoscopy is the first‐line tool to identify the type and extension of oesophageal and gastric damage. A barium swallow performed 2–3 weeks after the CI may identify oesophageal stricture. Dysphagia occurs in about one‐third of cases. Regarding the nutritional status, children with dysphagia and/or oesophageal strictures may have lower fat reserves or muscle mass than the cases without these complications, meaning impaired nutritional status. All patients should be hospitalized for evaluation and treatment. Hemodynamic stabilization and adequacy of the patient’s airway are priorities; vomiting induction and gastric lavage are contraindicated. Methylprednisolone in II-b oesophageal burns for 3 days diminishes the risk of stricture. Selected cases will require oesophageal dilatations, gastrostomy or oesophageal replacement by colon or stomach. There are other promising agents in the management of caustic oesophageal strictures
Influence of Dietary Algae Meal on Lipid Oxidation and Volatile Profile of Meat from Lambs with Competent Reticular Groove Reflex
Dietary lipid sources influence intramuscular fatty acid composition, which in turn may affect the volatile profile of meat. The aim of this work was to investigate the effects of marine algae supplementation (Aurantiochytrium limacinum) on volatile compounds of cooked lamb meat. Forty-eight lambs with 42 days of age were divided into three groups: lambs fed a conventional diet without algae meal supplementation (NOALG), lambs with competent reticular groove reflex (RGR) fed the same diet supplemented with 2.5% marine algae meal mixed in the concentrate (ALGCON), and lambs with competent RGR, receiving the same diet and fed with 2.5% marine algae meal in a milk replacer to bypass the rumen (ALGMILK). Lipid and protein oxidation in raw meat was assessed and volatile compounds in grilled meat were determined. The highest and lowest lipid oxidations were observed in the ALGMILK and NOALG groups, respectively. Protein oxidation was unaffected. Out of 56 identified compounds, 12 volatiles significantly increased in both algae groups and 6 of them exclusively in the ALGCON treatment. Algae meal supplementation and its form of administration, either protected or not from rumen degradation, are important factors to consider in lipid oxidation and the aromatic profile of lamb meat
TNF-α and IL-10 downregulation and marked oxidative stress in Neuromyelitis Optica
<p>Abstract</p> <p>Background</p> <p>Neuromyelitis optica is a central nervous system demyelinating and inflammatory syndrome. The objective of this study is to identify cytokines related to the cellular immune response as well as blood brain barrier integrity and oxidative stress.</p> <p>Methods</p> <p>We performed a molecular characterization of cellular immune response and oxidative stress in serum from relapsing-NMO (R-NMO) patients and established the correlations between the clinical measurements and molecular parameters using the Bayesian approach.</p> <p>Serum samples from 11 patients with R-NMO diagnosed according to Wingerchuk criteria and matched in terms of age, gender and ethnicity with the healthy controls were analyzed. The levels of TNF-<it>α</it>, IFN-<it>γ</it>, IL-10, MMP-9, TIMP-1 and oxidative stress markers: malondialdehyde, advanced oxidation protein products, peroxidation potential, superoxide dismutase, catalase, and total hydroperoxides were measured.</p> <p>Results</p> <p>We found almost undetectable levels of TNF-<it>α</it>, a decreased production of IL-10 and a significant up-regulation of every oxidative stress biomarker studied. The insufficient production of TNF-<it>α </it>and IL-10 in R-NMO patients, which are two important players of T cell mediated immunoregulation, suggest an effector – regulator imbalance. The overproduction of oxygen reactive species as a consequence of the chronic inflammatory milieu is reflected on the excess of oxidative damage mediators detected. Furthermore, Multidimensional Scaling and a Bayesian linear regression model revealed a significant linear dependence between Expanded Disability Status Scale Kurtzke and TIMP-1; pointing to a possible predictive or prognostic value of this clinical-molecular relationship.</p> <p>Conclusion</p> <p>These results suggest that there is a breakdown in immunoregulatory mechanisms and noteworthy pro-oxidant environment contributing to NMO pathogenesis.</p
In vivo trypanosomicidal activity of imidazole- or pyrazole-based benzo[ g ]phthalazine derivatives against acute and chronic phases of chagas disease
The in vivo trypanosomicidal activity of the imidazole-based benzo[g]phthalazine derivatives 1−4 and of the new related pyrazole-based compounds 5 and 6 has been studied in both the acute and chronic phases of Chagas disease. As a rule, compounds 1−6 were more active and less toxic than benznidazole in the two stages of the disease, and the monosubstituted derivatives 2, 4, and 6 were more effective than their disubstituted analogs. Feasible mechanisms of action of compounds 1−6 against the parasite have been explored by considering their inhibitory effect on the Fe-SOD enzyme, the nature of the excreted metabolites and the ultrastructural alterations produced. A complementary histopathological analysis has confirmed that the monosubstituted derivatives are less toxic than the reference drug, with the behavior of the imidazole-based compound 4 being especially noteworthy.The authors thank the Santander-Universidad Complutense Research Program (Grant GR58/08-921371-891), the Spanish MEC Project (Grant CGL2008-03687-E/BOS), and the MCINN Projects (CTQ2009-14288-C04-01 and Consolider CSD2010-00065) for financial support
A high concentration of TGF-β correlates with opportunistic infection in liver and kidney transplantation
Transforming growth factor-β (TGF-β) has been associated with numerous human infections, but its role in the occurrence of opportunistic infection (OI) after solid organ transplantation remains unexplored. This study aimed to assess the utility of the TGF-β following in vitro stimulation of whole peripheral blood (WPB) as a surrogate biomarker of post-transplant OI in a cohort of liver and kidney recipients. Thirty liver and thirty-one kidney transplant recipients were recruited to be prospectively monitored for one-year post-transplantation. Enzyme-linked immunosorbent assay (ELISA) was performed to calculate IFN-γ, IL-17, IL-10 and TGF-β concentration in the supernatant from the activated WPB. Recipients showed higher TGF-β concentrations compared to IFN-γ, IL-17, IL-10 at baseline, although these differences were not significant between INF and NoINF. However, recipients who developed an OI within the first sixth months had a higher concentration of TGF-β than those without OI. A concentration of TGF-β > 363.25 pg/ml in liver and TGF-β > 808.51 pg/ml in kidney recipients were able to stratify patients at high risk of OI with a sensitivity and specificity above 70% in both types of solid organ transplantations. TGF-β could provide valuable information for the management of liver and kidney recipients at risk of post-transplant infection.Our work was possible thanks to the support and funding obtained from the “Instituto de Salud Carlos III (ISCIII)”, Spanish Ministry of Health (Grant Number PI15/01370 and P19/01194); and co-funding by the European Union from the European Regional Development Fund (ERDF) with the principle of “A manner to build Europe”
Dietary modifications engaged in young muslims of Ramadan fasting
La práctica del precepto islámico del Ramadán (R),
impone a las personas que lo practican importantes modificaciones
fisiológicas y psicológicas debido a las restricciones
hídricas y dietéticas a las que se ven sometidos, lo que tiene
una especial repercusión en el rendimiento físico e intelectual
de los estudiantes musulmanes, particularmente en
sociedades multiculturales de tipo occidental, en las que no
se producen ajustes horarios, en las actividades diarias.
Entre las modificaciones introducidas en los hábitos de
vida, por esta causa, destacan los cambios dietéticos, tanto
cualitativos como cuantitativos. Por la relevancia de la cuestión
y ante el escaso conocimiento de los efectos del Ramadán
en estudiantes adolescentes que viven en sociedades no
islámicas, se plantea como objetivo de este estudio, el análisis
de las modificaciones en macronutrientes, ocurridas
durante el R, en un grupo de alumnos musulmanes de
ambos sexos, con el fin de solucionar y prevenir algunos de
los problemas que se plantean en este periodo.
Material y método: Se seleccionaron 55 jóvenes musulmanes
(24 hombres y 31 mujeres) con edades comprendidas
entre 15 y 18 años, que realizan el R y se analizó la
dieta mediante inventario de 3 días, una semana antes del
ayuno y en la segunda semana durante éste.
Resultados: En el R, no hay cambios significativos en la
ingesta calórica de los hombres y sí en el de las mujeres.
Se incrementa el consumo de carbohidratos y proteínas y
desciende el de grasas.
Discusión: Los cambios en R conducen a una dieta más
ajustada a las recomendaciones nutricionales, y a esto
parece haber contribuido el hecho de que los participantes
llevaron a cabo sus comidas en el seno doméstico
donde, a pesar del corte occidental de la población, se deja
sentir una importante influencia de las tradiciones y hábitos
magrebíes, por el contacto fronterizo con Marruecos.The practice of the Islamic precept of Ramadan (R)
imposes to those who practice it important physiological
and psychological changes due to the water and dietary
restrictions they are subjected to, which has a particular
impact on the Muslim students’ physical and psychological
performances, particularly in multicultural Western
societies, where there are no schedule adjustments in
daily activities. Among the changes in lifestyle, consequently,
the dietary changes are stressed, both qualitative
and quantitative. Due to the importance of this issue and
facing the limited knowledge the Muslim teenagers who
live in non-Islamic societies have about the effects of
Ramadan, it is suggested as main objective of this study
the analysis of changes in nutrients during R in a group of
Muslim students of both sexes, in order to solve and prevent
some of the problems shown in this period.
Materials and methods: 55 Muslim youngsters were
selected (24 men and 31 women) aged between 15 and 18,
who practise R; and the diet was analysed by inventory
over 3 days, one week before fasting and in the second
week during it.
Results: In R there are no relevant changes in caloric
intake. The consumption of carbohydrates and proteins is
increased, and that of fat is decreased.
Discussion: the changes in R lead to a diet more regulated
to nutritional recommendations; and to this seems
to have contributed the fact that the participants took
their meals at home, where, in spite of the Western cut of
the population, it is felt an important influence of North
African traditions and habits, due to its border contact
with Morocco
Benthic Fauna of Littoral and Deep-Sea Habitats of the Alboran Sea: A Hotspot of Biodiversity
En prens
Chronic Exposure to Arsenic and Markers of Cardiometabolic Risk: A Cross-Sectional Study in Chihuahua, Mexico
BackgroundExposure to arsenic (As) concentrations in drinking water > 150 μg/L has been associated with risk of diabetes and cardiovascular disease, but little is known about the effects of lower exposures.ObjectiveThis study aimed to examine whether moderate As exposure, or indicators of individual As metabolism at these levels of exposure, are associated with cardiometabolic risk.MethodsWe analyzed cross-sectional associations between arsenic exposure and multiple markers of cardiometabolic risk using drinking-water As measurements and urinary As species data obtained from 1,160 adults in Chihuahua, Mexico, who were recruited in 2008–2013. Fasting blood glucose and lipid levels, the results of an oral glucose tolerance test, and blood pressure were used to characterize cardiometabolic risk. Multivariable logistic, multinomial, and linear regression were used to assess associations between cardiometabolic outcomes and water As or the sum of inorganic and methylated As species in urine.ResultsAfter multivariable adjustment, concentrations in the second quartile of water As (25.5 to < 47.9 μg/L) and concentrations of total speciated urinary As (< 55.8 μg/L) below the median were significantly associated with elevated triglycerides, high total cholesterol, and diabetes. However, moderate water and urinary As levels were also positively associated with HDL cholesterol. Associations between arsenic exposure and both dysglycemia and triglyceridemia were higher among individuals with higher proportions of dimethylarsenic in urine.ConclusionsModerate exposure to As may increase cardiometabolic risk, particularly in individuals with high proportions of urinary dimethylarsenic. In this cohort, As exposure was associated with several markers of increased cardiometabolic risk (diabetes, triglyceridemia, and cholesterolemia), but exposure was also associated with higher rather than lower HDL cholesterol.CitationMendez MA, González-Horta C, Sánchez-Ramírez B, Ballinas-Casarrubias L, Hernández Cerón R, Viniegra Morales D, Baeza Terrazas FA, Ishida MC, Gutiérrez-Torres DS, Saunders RJ, Drobná Z, Fry RC, Buse JB, Loomis D, García-Vargas GG, Del Razo LM, Stýblo M. 2016. Chronic exposure to arsenic and markers of cardiometabolic risk: a cross-sectional study in Chihuahua, Mexico. Environ Health Perspect 124:104–111; http://dx.doi.org/10.1289/ehp.140874
Home parenteral nutrition (HPN) registry in spain for the years 2007, 2008 and 2009 (Nadya-SENPE group)
Objetivo: Comunicar los datos del registro de Nutrición
Parenteral Domiciliaria (NPD) del grupo de trabajo
NADYA-SENPE de los años 2007, 2008 y 2009.
Material y métodos: Recopilación de los datos del registro
“on-line” introducidos por las Unidades responsables
del seguimiento de la NPD desde el 1 de enero de 2007 al 31
de diciembre de 2009 dividido por años naturales.
Resultados: Año 2007: Se registraron 133 pacientes
con NPD (61 hombres y 72 mujeres), de 21 hospitales. La
edad media de los 119 pacientes mayores de 13 años fue de
53,7 ± 14,9 años, y de 3,6 ± 3,6 años la de los 14 pacientes
que no los superaban. La patología más frecuente fue la
neoplasia (24%) seguida de las alteraciones de la motilidad
intestinal y la enteritis posradiación (ambas 14%).
En el 43% de los casos el motivo de indicación fue el síndrome
de intestino corto, seguido de malabsorción (27%)
y obstrucción intestinal (23%). Los catéteres más utilizados
fueron los tunelizados (69%) y los reservorios subcutáneos
(27%). Las complicaciones mas frecuentes fueron
las sépticas relacionadas con el catéter con una tasa de
0,92 infecciones por cada mil días de NPD. La duración de
la NPD fue superior a los dos años en el 50% de los casos.
Al acabar el año seguía en activo el 71,4% de los pacientes;
la muerte fue la principal causa de la finalización de
la NPD (57,5%). El 26% de los pacientes se consideraron
candidatos al trasplante intestinal.
Año 2008: Se registraron 143 pacientes con NPD (62
hombres y 81mujeres), de 24 hospitales. La edad media
de los 133 pacientes mayores de 13 años fue de 54,7 ± 13,9
años, y de 3,7 ± 0,6 años la de los 10 pacientes que no los
superaban. La patología más frecuente fue la neoplasia
(20%) seguida de la enteritis rádica (14%) y las alteraciones
de la motilidad intestinal (13%). En el 44% de los
casos el motivo de indicación fue el síndrome de intestino
corto, seguido de malabsorción (28%) y obstrucción
Nutriintestinal
(20%). Los catéteres más utilizados fueron los
tunelizados (60%) y los reservorios subcutáneos (29%).
Las complicaciones mas frecuentes fueron las sépticas
relacionadas con el catéter con una tasa de 0,50 infecciones
por cada mil días de NPD. La duración de la NPD fue
superior a los dos años en el 67% de los casos. Al acabar el
año seguía en activo el 71,6% de los pacientes; la muerte
fue la principal causa de la finalización de la NPD
(52,4%). El 29% de los pacientes se consideraron candidatos
al trasplante intestinal.
Año 2009: Se registraron 158 pacientes con NPD (62
hombres y 96 mujeres), de 24 hospitales. La edad media
de los 149 pacientes mayores de 13 años fue de 55,2 ± 13,0
años. La patología más frecuente fue la neoplasia (25%)
seguida de la enteritis rádica (12%) y las alteraciones de
la motilidad intestinal (11%). En el 42% de los casos el
motivo de indicación fue el síndrome de intestino corto,
seguido de malabsorción y obstrucción intestinal (ambas
23%). Los catéteres más utilizados fueron los tunelizados
(60%) y los reservorios subcutáneos (36%). Las complicaciones
mas frecuentes fueron las sépticas relacionadas
con el catéter con una tasa de 0,67 infecciones por cada
mil días de NPD. La duración de la NPD fue superior a los
dos años en el 58% de los casos. Al acabar el año seguía en
activo el 79,2% de los pacientes; el paso a alimentación
oral fue la principal causa de la finalización de la NPD
(48%). El 23% de los pacientes se consideraron candidatos
a trasplante intestinal.
Conclusiones: Se observa un aumento progresivo de
los pacientes registrados respecto a años anteriores con
una prevalencia muy variable según comunidades autónomas.
La principal patología sigue siendo la neoplasia,
que ocupa el primer lugar desde 2003. Se aprecia una disminución
de las complicaciones sépticas relacionadas con
el catéter en los dos últimos años, siendo la tasa de 2008 la
más baja desde la creación del registroObjective: To report the data of the Home Parenteral
Nutrition (HPN) registry of the NADYA-SENPE working
group for the years 2007, 2008 and 2009.
Methodology: We compiled the data from the on-line
registry introduced by the responsible Units for the monitoring
of HPN from January 1st 2007 to December 31st
2009. Included fields were: age, sex, diagnosis and reason
for HPN, access path, complications, beginning and end
dates, complementary oral or enteral nutrition, activity
level, autonomy degree, product and fungible material
supply, withdrawal reason and intestinal transplant indication.
Results: 2007: 133 patients with HPN were registered
(61 males and 72 females), belonging to 21 hospitals.
Average age for the 119 patients older than 13 years old
was 53.7 ± 14.9 years, and 3.6 ± 3.6 y. for the 14 patients
under 14 years old. Most frequent pathology was neoplasm
(24%), followed by intestinal motility disorders
and actinic enteritis (14% both). The reason for HPN provision
was short bowel syndrome (43%), malabsorption
(27%), and intestinal obstruction (23%). Tunnelled
catheters were mostly used (69%), followed by implanted
port-catheters (27%). Catheter related infections were
the most frequent complications, with a rate of 0.92
episodes/103 HPN days. HPN was provided for more than
two years in 50% of the cases. By the end of 2007, 71.4%
of the patients remained active; exitus was the most frequent
reason to end HPN (57.5%). 26% of the patients
were eligible for intestinal transplant.
2008: 143 patients with HPN were registered (62 males
and 81 females), belonging to 24 hospitals. Average age
for the 133 patients older than 13 years old was 54.7 ± 13.9
years, and 3.7 ± 0.6 y. for the 10 patients under 14 years
old. Most frequent pathology was neoplasm (20%), followed
by actinic enteritis (14%) and intestinal motility
disorders (13% ). The reason for HPN provision was
short bowel syndrome (44%), malabsorption (28%), and
intestinal obstruction (20%). Tunnelled catheters were
mostly used (60%), followed by implanted port-catheters
(29%). Catheter related infections were the most frequent
complications, with a rate of 0.50 episodes/103 HPN
days. HPN was provided for more than two years in 67%
of the cases. By the end of 2008, 71.6% of the patients
remained active; exitus was the most frequent reason to
end HPN (52.4%). 29% of the patients were eligible for
intestinal transplant.
2009: 158 patients with HPN were registered (62 males
and 96 females), belonging to 24 hospitals. Average age
for the 149 patients older than 13 years old was 55.2 ± 13.0
years. Most frequent pathology was neoplasm (25%), followed
by actinic enteritis (12%) and intestinal motility
disorders (11%). The reason for HPN provision was short
bowel syndrome (42%), malabsorption, and intestinal
obstruction (23% both). Tunnelled catheters were mostly
used (60%), followed by implanted port-catheters (36%).
Catheter related infections were the most frequent complications,
with a rate of 0.67 episodes/103 HPN days.
HPN was provided for more than two years in 58% of the
cases. By the end of 2009, 79.2% of the patients remained
active; full oral nutrition was the most frequent reason to
end HPN (48%). 23% of the patients were eligible for
intestinal transplant.
Conclusions: We observe an increase in registered
patients with respect to previous years, with a very different
prevalence among regions. Neoplasia remains as the
main pathology since 2003. We observe a decrease in
catheter-related infections in the last two years, being the
2008 rate the smallest since the register’s beginning
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